AESTHETIC LASER & SURGERY FACILITY; NPI #1841361052

Contact Information

AESTHETIC LASER & SURGERY FACILITY

416 GORDON AVE
THOMASVILLE, GA 31792-6644

Phone: 229-228-7200
Fax: 229-228-5193
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Ambulatory Surgical	261QA1903X	49	Ambulatory Surgical Center

Indicates primary specialty

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NPI Profile & details for AESTHETIC LASER & SURGERY FACILITY

NPI # 1841361052

LBN Legal business name AESTHETIC LASER & SURGERY FACILITY

Authorized official G. COURTNEY HOUSTON - (MEDICAL DIRECTOR)

Entity Organization

Organization subpart ¹ No

Enumeration date 11/10/2006

Last updated 08/22/2020 - About 6 years ago

Identifiers

License #

136-113

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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